Comprehensive Sexuality Education
1. Context and background
Estonia was the first country of the former Soviet Union to officially introduce school-based sexuality education in 1996. Over the past two decades, the country has experienced notable downward trends in adolescent pregnancies, STIs, and HIV, accompanied by improvements in sexual knowledge and safe sexual behaviour. The first Youth Counselling Services addressing sexual health matters were set up in 1991–1992, and later in 1998, and online counselling was also offered by the Youth Counselling Services. Currently, a network of sexual and reproductive health (SRH) clinics provides young people with both individual counselling and group sexuality education.
2. Terminology
Sexuality education is referred to as ‘personal, social and health education’ (formerly 'human studies').
3. Laws and policies
3.1. Relevant international/regional agreements to which Estonia is a signatory
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INTERNATIONAL |
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Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 1991 |
Acknowledges the need to guarantee sexuality education free from discrimination and stereotypes, conveying gender equality values. |
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Convention on the Rights of the Child (CRC) Ratification date: 1991 |
Commits to the right to access appropriate health-related information. |
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Convention on the Rights of Persons with Disabilities (CRPD) Ratification date: 2012 |
Commits to the highest attainable standard of health for persons with disabilities. |
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International Covenant on Economic, Social and Cultural Rights Ratification date: 1991 |
Acknowledges that the right to sexual and reproductive health is an integral part of the right to health. |
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The 1994 International Conference on Population and Development (ICPD) Programme of Action |
Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics. |
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3.2. Relevant national laws and policies mandating comprehensive sexuality education
In its regulations, the 1992 Republic of Estonia Education Act (amended in 2022) does not cover sexuality education.
The 2010 Basic Schools and Upper Secondary Schools Act requires that certain compulsory subjects from the national curriculum, such as social studies, be included, including personal, social, and health education, history, civics, and citizenship education.
Estonia included sexuality education as a subject in the new curriculum in 1996. The 2010 Basic Schools and Upper Secondary Schools Act includes Personal, Social, and Health Education as a compulsory subject of the national curriculum, in the field of social studies. It is included in the 2011 National Curriculum for Basic Schools and the 2011 National Curriculum for Upper Secondary Schools as a compulsory subject in the field of social studies.
3.3. Curricula
Mandatory or optional
Sexuality education is mandatory in primary and secondary education.
Model of delivery
The sexuality education programme is delivered both as a stand-alone subject and integrated into biology classes. The subject is called Personal, Social and Health Education (formerly called ‘Human Studies’). The subject includes 35 lessons a year in grades 2-3 and 5-8, and covers sexuality education topics, along with communication skills, drug and alcohol prevention, nutrition, and physical activity, among others. Sexuality education is also included in biology classes, in relation to reproduction, contraceptive methods and the concept of family planning. The National Curriculum for Upper Secondary Schools (grades 10-12) contains more on sexuality education, which is also mandatory within the Personal Social and Health Education discipline for students who continue their studies past 9th grade. In addition, 'health and safety' is included as a cross-curricular topic.
Comprehensiveness of content
The curriculum has been adapted twice, in 2002 and 2010. There are two national curricula, one for primary schools (until the age of 16) and one for upper secondary schools. The curricula take a holistic approach, including evidence-based knowledge on human sexual development and behaviour, social skills and positive attitudes and values towards sexuality.
The sexuality education programme is comprehensive. The issues concerning sexuality and health are delivered according to students’ age. Apart from biological aspects, there is an emphasis on attitudes and the development of behavioural skills. Information on youth-friendly SRH clinics is also provided. For students aged 5-8, the Estonian programme has strong content on interpersonal relationships and communication, negotiation, and decision-making. It covers human rights and gender-focused topics. For students aged 9-12, there are components on communication, negotiation, and decision-making, human development, and youth empowerment. In the curricula for 12-15 year-old learners, skills development remains the strongest learning domain. For adolescents (15-18), communication, negotiation, decision making and human development concepts are fully integrated. Life skills are the strongest learning domain, while topics around human rights and gender are deeply embedded.
Learning resources
Guidelines and educational materials for teachers and students have been developed by the National Institute of Health Development, teacher organizations, the Estonian Sexual Health Association and Tartu University. However, schools are free to choose from different teaching materials.
3.4. Teachers
Pre- and in-service teacher training programmes on sexuality education are offered. Sexuality education is part of the curriculum of teacher-training colleges and universities; it is mandatory for all teachers in training who have chosen health education as one of their three areas of specialization for primary and secondary education. The National Institute of Health created the teacher training manual for sexuality education, which guides all training. It is used to develop courses on gender stereotypes, dating violence, and healthy relationships.
3.5. Schools
Since 1991, Estonia has created 16 youth-friendly SRH clinics free of charge for young people under the age of 25. Services are offered in Estonian and Russian. The youth clinics are departments of larger health care institutions, private gynaecological practices, or private health care companies. The clinics can be public or private and they all receive a budget from the Government (through the Health Insurance Fund). Most clinics are open daily and serve young people exclusively. Services include STI consultations, which include: STI testing, treatment and follow-up consultations; HIV services; voluntary confidential counselling and testing, and in case of an HIV-positive result referral for specialist consultation; contraceptive consultations, which include information and counselling on contraceptives, prescription and renewal of contraceptive prescriptions, and the insertion of contraceptive devices; SRH counselling, which includes counselling, pregnancy diagnostics, and referrals for antenatal care or safe abortion, psychological counselling, human papillomavirus vaccination and counselling, and a range of other SRH services; and sexuality education lessons held at schools or youth clinics. The clinics also offer online counselling, anonymously and without charge. There is a regular audit of answers and feedback to team members. The 2010 Basic Schools and Upper Secondary Schools Act, which regulates the basis for the organization of studies of basic schools and upper secondary schools, dictates the provision of health services at schools. The Act also covers the rights and duties of students and students’ parents or guardians, the rights and duties of school employees, the basis for the management and funding of schools, and the basis for administrative supervision of teaching and educational activities at schools,
4. Governance
4.1 Responsible ministries
The Ministry of Education and Research is responsible for the curriculum, but local governments are responsible for delivering it. The Estonian Sexual Health Association is the national provider of sexuality education in schools.
4.2. Level of responsibility/decentralization and autonomy
According to the 2010 Basic Schools and Upper Secondary Schools Act, on the basis of national curricula, the school draws up a school curriculum as the underlying document of study in the school, and sets out the choices made from national curricula, which reflect the unique characteristics of the school. However, all schools must comply with the national curricula requirements, which include providing personal, social and health education.
4.3. Government budget allocation
No information was found.
5. Monitoring and reporting
Estonia does not include SRH elements in the national EMIS or school inspection tools. The country has administered several surveys that include data on school-based sexuality education, including the Youth Sexual Maturation Survey, the Comparative Survey on Human and Intimate Relationships, the Estonian Women’s Health Survey, and the Health Behaviour in School-age Children Survey. It has also published a country-level progress report on HIV every year since 2014.
